The Government is trying to reassure women fitted with PIP implants to prevent a rush for NHS surgery to remove faulty breast implants.The adverts, to run in a number of national newspapers at the weekend, will emphasise there is “no clear evidence” that the French made implants cause more harm than other brands.

Almost £135,000 is being spent by the Department of Health on the campaign, which will also run in social media sites. Posters will appear in GPs’ surgeries and hospitals as well.

The advert reads: “The latest advice from the NHS and plastic surgery experts is that women with PiP breast implants do not need to have them removed unless they have symptoms such as pain and tenderness.

“There is no link to cancer and there is no clear evidence of an increased risk of harm compared to other brands of breast implants.”

However, it also states, in large-type at the top of the advert: “The NHS will support women with PiP breast implants.”

Clarifying the situation for those who received implants as part of private breast enlargement operations, it states: “”The NHS will remove your implants if your doctor agrees, but the NHS will not replace implants unless it is clinically necessary.”

It advises those worried about whether they have implants made by Poly Implant Prothese (PIP), which contain industrial-grade silicone, to find out if they have them, to speak to their specialist or GP, and “agree what’s best for you”.

Despite the campaign, Fazel Fatah, president of the British Association of Aesthetic Plastic Surgeons (BAAPS), said the organisation’s stance remained that all 40,000 women fitted with them in Britain should have them removed.

He said: “We remain steadfast in our recommendation to the public of precautionary removal of these defective devices. Although there is no immediate health risk, the gel within these implants is simply not meant to be inside the human body.”

A survey of its 230 members found 95 per cent agreed that “it should be the clinics and hospitals that should pay for the replacement surgery, rather than burden the taxpayer with these costs”.

Women given the PIP implants are due to protest in London on Saturday at the reluctance of private firms like Harley Medical Group, The Hospital Group and Transform Cosmetic Surgery to fund removal and replacement surgery.

Explaining the rationale for the campaign, Andrew Lansley, the Health Secretary, said: “The refusal of some clinics to help their patients has left some of those women worried and confused.

“That’s why we are running this ad campaign, to give women clear, definitive advice about what course of action they should take. I hope it helps women decide what is best for them. We have made it very clear to private companies what we expect of them – to provide their patients with the aftercare that they need and deserve.”

“I do not think it is fair to the taxpayer or other NHS patients for the NHS to foot the bill.  We will pursue private clinics with all means at our disposal to avoid this.”

Professor Sir Bruce Keogh, NHS medical director and leader of an expert group on PIP implants convened by Mr Lansley, said: “At present there is insufficient evidence to recommend routine removal of these implants.

“But I know women will be worried. That’s why the expert group supports the NHS offer and believes the private industry should do the same.”

From: http://www.telegraph.co.uk/Breast-implant-scandal-Government-campaign-to-reassure-women

Ministers have agreed to pay for the removal of the French made PIP breat implants for women who had them on the NHS, and have called on private clinics to acknowledge their “moral duty” to offer the same service.Although the Department of Health said it would “pursue private clinics with all means at its disposal to avoid the taxpayer picking up the bill”, it confirmed on Friday night that it would help women if their clinic was no longer in operation or refused to care for them.

Officials say the implants – thought to have been fitted in some 52,000 women who wanted larger breasts for cosmetic reasons or after cancer surgery – only need to be replaced if they have ruptured but will also carry out the procedure if the patients are worried about them.

Most independent providers have agreed to provide free surgery for their patients who received implants made by the now-defunct Poly Implant Prothèse (PIP) – which were filled with non-medical grade silicone intended for use in mattresses – at least one is holding out while another has so far refused to reveal its policy.

Transform Cosmetic Surgery said the Government needed to “accept its responsibility” for the problem as the implants had been approved for use by a watchdog, the Medicines and Healthcare products Regulatory Agency.

Transform carries out 6,000 breast augmentation procedures a year, and estimates it has fitted some 4,000 women with PIP implants in recent years.

The clinic is currently refusing to pay for them to be removed and replaced and is charging women £2,800 per procedure, although it insists most implants are not at risk of malfunctioning. Some patients have already been booked in for the operation.

It said it would review its stance this week, but if it remains unchanged it could mean the Government has to step in and pay for these women’s operations, at a cost of up to £11.2m.

Nigel Robertson, the chief executive of Transform Cosmetic Surgery, said in a statement: “Transform is fully committed to supporting the Department of Health in its efforts to end the uncertainty and anxiety of British women affected by the PIP situation and awaits a response to its request for an urgent meeting to discuss the way forward.

“It is important to recognise that this crisis is the result of failed regulation of breast implants, which were approved for use. The Government needs to accept its responsibility for this situation and work constructively with us to find a workable solution.”

The other major clinic yet to announce its decision is The Hospital Group.

It is telling patients there is “no evidence to suggest routine removal” of PIP implants but will replace those that have already ruptured “free of charge”.

Other leading providers including BMI Healthcare, Nuffield Health and Spire have agreed to offer free removal of the PIP implants.

Michelle Victor, a solicitor at Leigh Day & Co, said the firm had already been contacted by women seeking help to make private clinics pay for the replacement of their PIP implants.

She said that although the clinics themselves were not responsible for making them, the implants were “not fit for purpose” and so cosmetic surgery groups should remove them.

From: http://www.telegraph.co.uk/Leading-cosmetic-surgery-group-refusing-to-fund-new-breast-implants

Ray King, chief executive of medical group Bupa, has called for a “chronic underfunding” of the care homes system to be addressed “urgently”.He warned that the NHS may face a “bed blocking” crisis unless fees paid to care home operators such as Bupa rise.

Mr King said the number of care home places in the UK will fall unless operators get “fairer fees”.

His comments came as he unveiled a sharp rise in Bupa’s overall global profits, but a fall in the UK division.

About 70% of Bupa’s 18,000 care residents, in its more than 300 homes, are paid for by local authorities- and local authorities pay for well over half of England’s 390,000 care home residents.

But Mr King said operators are seeing a real terms fall in fees as authorities’ budgets come under pressure.

Bupa believes there could be a 100,000 care home bed shortfall within 10 years, if investment in the sector is not increased and current funds are not ring fenced.

This could put pressure on the NHS to take in people who would normally go into care homes.

Bupa, which is a provident company with no shareholders, said its global care services division lifted revenues by 1% to £589 million and profits by 2% to £67.7 million in the half year to June.

But the UK care arm saw a “marginal” fall in profits and occupancy, a situation that could worsen.

Mr King said: “We are calling for the chronic underfunding of the social care system to be urgently addressed. At the absolute minimum, there must be a real terms increase in funding for local authority purchased care home places over 2012-15.”

A nationwide lottery offering couples the chance to win IVF fertility treatment was strongly criticised. At its launch, a UK-based charity offered people – couples or singles of both sexes – the chance to win £25,000 for a round of IVF treatment at a “top clinic”, in return for a £20 ticket.

The lottery is being organised by the charity To Hatch, founded by Camille Strachan, 38, to help people who are struggling to conceive. The winner of the lottery, which is licensed by the UK Gambling Commission, will be randomly selected by a computer in September. Further monthly draws are then planned.

Ms Strachan says she hoped the lottery “can ease the burden on the NHS and reduce the stress on some of those who are struggling.”

It is understood that a number of UK clinics have refused to participate, sparking rumours that a clinic in Barbados would be one of the destinations. Ms Strachan has declined to reveal which “top” clinics would offer the treatment.

The Human Fertilisation and Embryology Authority (HFEA) have criticised the move as “wrong and entirely inappropriate”. They described it as running “counter to the ethos that underpins our regulatory system and clinical practice”.

Dr Allan Pacey, a fertility expert at the University of Sheffield and a spokesperson for the British Fertility Society, said: “In my view it’s a slippery slope to be dishing out healthcare like this, particularly when it comes to children. My mother and father used to say they found me under a gooseberry bush – can you imagine telling a child that he or she was won in a raffle?

“Ethics aside, I think it is precisely the current postcode lottery of NHS funding which makes this charity think it can make this venture a success. Couples either find they can’t get access to NHS treatment or they get only a single attempt and therefore need to fund any further treatment privately if that is unsuccessful.”

Despite criticism of the charity, public responses on internet chat forums were mixed. Although the majority expressed misgivings, hundreds of people indicated on Facebook and Twitter that they intended to buy tickets.

Many took the view that the lottery is a good idea, given what is widely perceived as a cut in the provision of IVF treatment on the NHS.

A spokesman for the Gambling Commission, which regulates lotteries, said: “The commission plays no statutory role in judging ethical questions that fall outside of the Gambling Act 2005. A licence is granted if all the criteria are met.”

From: http://www.independent.co.uk/fertility-doctors-attack-unethical-16320-ivf-raffle

Dr Pierre Dukan, the weight loss guru, whose diets are popular with Gisele Bundchen and Carole Middleton, has lost in court against a rival he accused of libel, and has been fined himself.
Dr Dukan, the creator of a diet which has swept the globe, had filed a legal complaint against Jean-Michel Cohen, who criticised the protein-rich diet in a magazine.

A Paris court ruled on Tuesday that there was nothing libelous about Dr Cohen’s comments, and ordered Dukan to pay £2,700 in damages for “abusive procedure.”

Dr Cohen had warned that Dr Dukan’s methods could lead to serious health problems among some patients.

Dr Dukan issued a statement on Tuesday defending the safety of his diet and suggested Dr Cohen was jealous of the “Dukan phenomenon.”

Dukan’s book was France’s best-selling publication last year and is also a US best-seller. The protein-based diet urges against counting calories, instead allowing dieters to eat as much as they like from a limited list of foodstuffs.

Dr Cohen’s diet says readers can eat anything they like providing they stick to one of four calorie-based programmes of up 1,600 calories a day. The overall aim is to foster good eating habits and take regular exercise.

From: http://www.telegraph.co.uk/Weight-loss-guru-Pierre-Dukan-loses-libel-suit

Drugs used to stimulate the ovaries of older women undergoing IVF treatment may be causing genetic defects in the embryo which have until now gone undetected.
Scientists have discovered abnormalities in the chromosomes of eggs from women over 35 years of age who had been treated with synthetic hormones to stimulate their ovaries prior to IVF.

The researchers said they were surprised to find the chromosome defects which appeared to have occurred during the second stage of the specialised process of cell division that leads to the creation of the human egg cell.

Chromosome defects in eggs were previously considered to have resulted in the first stage of cell division, which occurs when a woman was herself a foetus in the womb. Finding them during the second stage, which occurs at ovulation, therefore suggests they may have resulted from the hyperstimulation of the ovaries during IVF treatment.

The defects included abnormal variations from the usual number of 23 pairs of chromosomes. Three copies of chromosome 21 instead of the normal two, for instance, leads to babies with Down’s syndrome. As women get older it becomes increasingly difficult for them to produce enough viable eggs for IVF treatment. It is common practice for older women to have their ovaries stimulated with stronger doses of drugs than is the case for younger women.

The results of the study are to be presented at a fertility conference in Stockholm this week but the scientists behind the research said that they wanted to reassure older women considering IVF treatment. They said further work needs to be done fully to explain the findings and there is no evidence to suggest that IVF babies of older women are at any higher risk of birth defects than babies conceived naturally by women of the same age.

“We found that some IVF eggs have up to seven chromosome abnormalities. This suggests the possibility that ovarian stimulation during the treatment may have caused some of these defects,” said Professor Alan Handyside, director of the London Bridge Fertility, Gynaecology and Genetics Centre, who led the study.

“These defects are unexpected and it may be that this is just an undiscovered aspect of biology. At the moment all we can say is that this is part of the natural process as women get older.”

The study, which will be presented at the European Society of Human Reproduction and Embryology, analysed more than 100 egg cells from 34 couples undergoing IVF treatment. The average maternal age was 40.

Scientists screened the chromosomes of the eggs and structures known as “polar bodies” that result from a type of cell division known as meiosis. Meiosis is a specialised form of division that results in eggs with half the normal complement of chromosomes – crucial to ensuring that the fertilised egg has the full complement of 46 chromosomes when it fuses with a sperm cell.

The first stage of meiosis occurs when the woman’s ovary is developing in the foetus before birth, when the dividing chromosomes are held together by a kind of cellular “glue” ready for the second stage of division at ovulation.

However, when the ovary of an older women is stimulated with synthetic hormones it is possible that this dislodges the glue prematurely. This might result in abnormal numbers of chromosomes to segregate into the resulting egg cell.

“Our evidence demonstrates that, following IVF, there are multiple chromosome errors in meiotic divisions, suggesting more premature separation of single chromosomes resulting in more random segregation,” Professor Hanyside said.

Stuart Lavery, a consultant gynaecologist at Hammersmith Hospital in London, said “This provides evidence that there is a problem, but it does not prove that it’s treatment related,” Mr Lavery said.

The most important conclusion to be reached from this research isn’t so much the “why” but that the screening process for eggs to be used in IVF must be improved.

It is possible to screen the chromosomes of so-called First Polar Body eggs, at least as part of research. This paper stresses the importance of also screening Second Polar Body eggs, those that have been fertilised.

Doing so will, we can now see, allow us to better identify eggs that have developed abnormalities that result in conditions like Down’s Syndrome.

The issue of whether drugs used to stimulate ovulation are having a role is two-fold. Are the drugs damaging the eggs or simply releasing those that would otherwise be discarded naturally because of abnormalities? Or it could be the drugs have no role at all? We don’t know.

One intriguing point is that if the drugs are a factor we would have anticipated having seen more cases of Down’s Syndrome among older mothers. They may be there but we haven’t detected any such increased risk yet – it means we need to research the possibility.

From:  http://www.independent.co.uk/ivf-drugs-may-be-linked-to-genetic-defects-discovered-in-embryos

Health groups in the UK are calling for a ban on cosmetic surgery prize draws.
The Independent Healthcare Advisory Services (IHAS) and the British Association of Aesthetic Plastic Surgeons (Baaps) have criticised procedures like boob jobs, face lifts and botox being offered through competitions.

They claim cosmetic surgery promotions are becoming more popular, especially over the last three months.

As well as prize draws, they say loyalty card schemes, divorcee packages, magazine competitions and online deals are also big concerns.

Some health experts believe advertising surgery in this way is encouraging young people to get treatments they don’t want or need.

Their concerns come days after My Big Fat Plastic Surgery Prize Draw, the first of a series of monthly events across the UK.

Tickets cost £25, with free entry into a lottery to win £4,000 worth of surgery of your choice.

The event was hosted in a nightclub in London and sponsored by a cosmetic surgery group. Runner-up prizes included fillers and semi-permanent make-up.

Jackie Lewis from Baaps specialises in breast surgery and criticised the draws.

“Cosmetic surgery should not be offered as a commodity prize,” she said. “This is not something that can be trivialised.

“If you’re going to subject yourself to a procedure which is irreversible with lifelong consequences, we recommend you think about it carefully first.”

The Government says you are free to choose where you have cosmetic surgery and the Advertising Standards Agency (ASA) insist all adverts must be socially responsible and not misleading.

From: http://www.bbc.co.uk/newsbeat/13908448

Silicone breast implants are relatively safe despite frequent complications and a small increased risk of the disease lymphoma, US drug regulators have found.
In a new report, the Food and Drug Administration said the risks were well enough understood that prospective patients could make informed decisions.

But it found as many as one in five breast augmentation patients had the implants removed within 10 years.

The FDA released a 63 page report on the safety of the silicone gel filled implants that compiled studies performed by the two companies approved to manufacture the the products.

Approximately five to 10 million women across the world have breast implants, the FDA said.

In 2006, the FDA approved two brands of silicone gel implants for women over 22, Allergan’s Natrelle implants and MemoryGel implants from manufacturer Johnson and Johnson’s Mentor division.

Silicone implants had been off the market since 1992, when the FDA removed them amid concerns about implant rupture and silicone leakage.

The agency allowed saline filled implants to remain on the market, and allowed limited distribution of silicone implants for mastectomy patients and other cases of medical necessity.

According to the new report, as many as one in five breast augmentation patients and half of breast reconstruction patients had to have the implants removed within 10 years.

Studies found no association between the silicone implants and connective tissue disease, breast cancer, or reproductive problems, the FDA reported.

But they did find a “very small” increased risk of anaplastic large cell lymphoma.

The most frequent complications from the implants included implant rupture, wrinkling, asymmetry, scarring, pain, and infection.

The report found that the risk of those local complications increases with time.

“Breast implants are not lifetime devices,” the FDA cautioned women. “The longer you have your implants, the more likely it will be for you to have them removed.”

But the agency also found that most women who had breast implants “report high levels of satisfaction with their body image and the shape, feel and size of their implants”.

“Despite frequent local complications and adverse outcomes, the benefits and risks of breast implants are sufficiently well understood for women to make informed decisions about their use,” the FDA concluded.

From: http://www.bbc.co.uk/news/world-us-canada-13883267

Home care provider Southern Cross has reached an agreement that gives it four months to find a solution to its financial difficulties.
Southern Cross will continue to run all 751 care homes during that time.

The process will be overseen by a restructuring committee consisting of representatives from the Darlington-based company and its 80 landlords.

Social services directors in England welcomed the announcement, but called for more information about the plans.

The process is still expected to lead to hundreds of its care homes being run by other operators.

Government representatives were not present at the meeting, but a Department of Health spokesman said the government had been “in constant contact over the course of discussions and remains ready to talk to all parties”.

“There is likely to be a series of meetings in coming days over the future of Southern Cross. Government is clear that all parties must work together to agree on a plan that will safeguard the continuity of care of residents,” the spokesman said.

Southern Cross and its landlords issued a joint statement after the meeting.

“The company and the landlords will work towards a consensual solution to the company’s current financial problems, which will be delivered over the next four months,” it said.

“The business, including the delivery of care, will continue to be the responsibility of the Southern Cross board, management team and staff who have the full support of both the landlords and lenders in the delivery of this important task.”

At the end of the process, Southern Cross is expected to end up operating under a different name with between 250 and 400 of its current 751 care homes.

Other operators will run the rest of the homes.

However, while welcoming the announcement as providing “great comfort” to thousands of older people, the group which represents social services directors in England said it wanted more information about the restructuring.

“It is clear that despite today’s (Wednesday’s) hard work by the parties involved, directors and their colleagues in local authorities throughout England and beyond will not have been given sufficient details of the shape of the future company: details which would help the important and well thought through contingency planning in which we have all been involved,” said Peter Hay, president of the Association of Directors of Adult Social Services (ADASS).

“The issue is the important one of confidence, and of ensuring that current residents of Southern Cross homes, as well as people who might be considering buying a place in one for themselves or for a relative, share in that confidence.”

The ADASS, whose members buy places in Southern Cross homes, added that unless the firm acted rapidly, there was a real danger it would lose business and market share.

Last month, Southern Cross said that it would stop paying about a third of its rental bill.

It is the UK’s largest care home operator with 31,000 residents, employing 44,000 staff, of which the company has already said it will cut 3,000.

From: http://www.bbc.co.uk/news/business-13786633

David Cameron has been urged to step in with a “rescue plan” for more than 30,000 elderly care home residents as Britain’s biggest private care provider faces financial ruin.
Elderly campaigners, charities and union leaders warned that the threat of collapse at Southern Cross Healthcare Group would be a “catastrophe” that could threaten the lives of residents at its 750 homes.

In response, Downing Street offered a “guarantee” that elderly and disabled people in Southern Cross homes would not lose out, but declined to say whether any emergency funding would be available.

The crisis comes as the public spending watchdog, the Audit Commission warns that the quality of services for elderly people will be under further threat as councils are forced to negotiate lower fees for private care places.

Southern Cross, which made a £311 million loss in the six months to the end of March, has blamed its problems on reduced council spending on long-term care. The group announced this week that it will be forced to cut the rent it pays to the landlords of the homes it runs by 30% for four months.

Saga, the over-50s group, called on ministers to draw up an urgent “rescue plan” for care homes in trouble. Ros Altmann, Saga’s director general, said: “The government and local authorities may have to step in and take control of the situation.

“There must be a plan for rescuing failed care homes, to protect their elderly residents properly. Of course some homes do fail, but not on a massive scale like this.

“Lives could be at risk as a result of Southern Cross collapsing.”

The GMB union, which has around 12,000 members working in the care homes, urged politicians across the UK to take action to help secure the future for the staff and the residents.

General secretary Paul Kenny said politicians must “sort out the uncertainty” the residents face. “These are not factories facing closure, they are a vital part of the social fabric of every community,” he said.

The Prime Minister’s official spokesman gave a guarantee that affected residents would not “lose out”.

“We are clear that we are putting the interests of residents at the top of the list,” he said. “It may well be in their interests to keep them in the same place. But I think we have to look at that very carefully and we have got to let this process continue with the company and the various other interested parties.”

However, he declined to discuss whether there was any contingency in care budgets to cover extra costs. Southern Cross is in talks with its landlords, who could force the group into deeper trouble if they refuse to agree to the rent cut.

Jamie Buchan, chief executive of Southern Cross, said he believed the company would survive, with fewer homes, but there would be no “need” for a government bail out. He told The Daily Telegraph: “I don’t think the Government would or would need to provide financial support.”

From: http://www.telegraph.co.uk/Southern-Cross-residents-need-government-rescue-plan